HRT vs Levo

[moose3101]

New to forum and have had Hashimoto diagnosed. GP prescribed 50mg of Levo. Already have Mirena coil and taking 1mg of Estradiol HRT. Is there any conflict between taking HRT and Levothyroxine. Appreciate knowing if they're compatible or not. GP has suggested not but meno(?), HRT and Thyroid and lots of meds ???

[SeasideSusie Remembering]

Moose3101

Welcome to the forum.

This is what the British Thyroid Association says:

However, women with pre-existing hypothyroidism treated with thyroxine, may require an increase in their thyroxine dose after starting HRT. Therefore it is useful for thyroid function tests to be re-checked after starting HRT.

I would take Levo and HRT at opposite ends of the day to minimise any absorption problem.

As you're new to Levothyroxine, always advised here is to take your Levo on an empty stomach, one hour before or two hours after food, with a glass of water only, no tea, coffee, milk, etc, and water only for an hour either side, as absorption will be affected. Take any other medication and supplements 2 hours away from Levo, some need 4 hours (iron, calcium, Vit D, magnesium, HRT, maybe some others too).

Always advised here, when having thyroid tests:

* Blood draw no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If looking for a diagnosis of hypothyroidism, an increase in dose of Levo or to avoid a reduction then we need the highest possible TSH

* Nothing to eat or drink except water before the blood draw. This is because eating can lower TSH and coffee can affect TSH.

* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.

* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin).

These are patient to patient tips which we don't discuss with phlebotomists or doctors.

Some information about Hashi's:

Fluctuations in symptoms and test results are common with Hashi's.

Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.

Some members have found that adopting a strict gluten free diet can help, although there is no guarantee.

Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.

You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Gluten/thyroid connection: chriskresser.com/the-gluten...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

thyroiduk.org.uk/tuk/about_...

Supplementing with selenium l-selenomethionine 200mcg daily is said to help reduce the antibodies, as can keeping TSH suppressed.

Hashi's and gut/absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies. It's essential to test Vit D, B12, Folate and Ferritin and address any problems. You are welcome to post these results, including reference ranges (plus units of measurement for Vit D and B12), for comment and suggestions for supplementing where necessary.

[moose3101 in reply to SeasideSusie]

Thank you!! I've been on HRT for many years so I guess take one of them late evening and the other in the morning. All hormones though but guess one lot of hormones to treat one issue and another lot of hormones to treat the other issue ?? Is there a worry that it's too much or are they simply quite different? Does that make any sense?

[SeasideSusie Remembering in reply to moose3101]

I have no personal experience of taking HRT so haven't looked into it.

[greygoose in reply to moose3101]

There are hundreds of different hormones in your body, and they all do different things. You can't replace one with another, they're not interchangable. So, if you need HRT and you need thyroid hormone replacement, they are what you should be taking.

[Localhero]

I take both Levothyroxine and HRT (Estradiol as a gel, and Progesterone at night as a pill). They seem to get along okay, although I do check my bloods regularly to try to make sure I’m taking the right doses.

[radd]

moose3101,

The conflict comes from oral oestrogen that raises binding globulins and risks binding excess thyroid hormone making it unavailable for use. When this happens NICE guidelines suggest a thyroxine dose increase.

Using transdermal body identical HRT bypasses the liver & so is considered safer for use with thyroid hormone replacement meds, although levels will still need to be initially monitored after the introduction of one or the other.

But whichever you take, HRT & thyroid meds can be taken at the same time as they are both hormones. I take mine together every morning.

[moose3101 in reply to radd]

Thank you